The glycopeptide CSF114(Glc) detects serum antibodies in multiple sclerosis

Synthetic glycopeptides have the potential to detect antibodies in multiple sclerosis (MS). In the present study, we analyzed the antibodies (IgM class, IgG class and IgG subclasses) to the synthetic glycopeptide CSF114(Glc) in the serum of 186 MS patients, 166 blood donors (BDs), 25 patients affected by meningitis/encephalitis, 41 affected by systemic lupus erythematosus (SLE) and 49 affected by rheumatoid arthritis (RA). The IgM antibody level to CSF114(Glc) was significantly increased in MS patients versus BDs (p<0.001) or versus other autoimmune diseases (SLE or RA, p<0.001). The IgG response was restricted to the subclass IgG2. IgM antibodies to CSF114(Glc) were found in 30% of relapsing/remitting MS patients and, at lower levels, in subjects affected by meningitis/encephalitis. The study of antibodies to CSF114(Glc) is a new, potential immunological marker of MS.     

Occupational stress in naval personnel

Introduction: Increased stress levels have been reported and it has been implicated for mental illness amongst service personnel. However no study has been reported among Indian naval sailors.     

Setting threshold limits for the significance of objectionable microorganisms in oral pharmaceutical products.

Due to the increasing number of immuno-compromised patients, increased attention is paid to the quantitation and identification of microorganisms in oral pharmaceutical products; therefore, a systematic approach is required by the manufacturers of non-sterile oral pharmaceuticals to evaluate the significance of microbial isolates other than primary pathogens and/or those in the product specification based on the number of organisms present, the type of dosage form, and the potential hazard to the user. Limits for objectionable microorganisms in oral products intended for use by immuno-compromised patient populations such as pediatric, HIV, cancer, etc., must be tighter than the limits for oral products intended for treating patients with diseases or conditions not affecting their immune systems because patients with deficient immune systems are more at risk of microbial infections. Smaller numbers of opportunistic pathogens become infectious when resistance mechanisms are impaired, either by severe underlying disease, or by use of immunosuppressive drugs. This article proposes a systematic approach for evaluating the significance of microbial isolates other than primary pathogens and/or those in the specification (e.g., Staphylococcus aureus and Pseudomonas aeruginosa) of non-sterile oral pharmaceutical products by setting appropriate threshold limits.     

Clinitron therapy and pain management in advanced cancer patients

Many patients with advanced malignancy develop bone metastases, pathologic fractures, and skin breakdown, all of which compromise comfort and interfere with the delivery of patient care. In 1986, 38 Clinitron beds were utilized at Calvary Hospital, a specialty hospital for advanced cancer, for patients who were immobile and/or had significant pain. Twenty-five patients were entered into an open study to assess and document this experience. Twenty-two patients experienced improved comfort while Clinitron therapy was in use. Global questionnaires relating to pain, comfort, appetite, and sleep were completed by the patients, their primary nurses, and attending physicians. No adverse effects were noted. The results suggest that Clinitron therapy is effective in promoting comfort in select advanced cancer patients. The difficulties encountered in research in this patient population are presented.     

Forced vergence fixation disparity parameters with and without a central fusion lock

The effect of a central fusion lock on forced vergence fixation disparity curve parameters, that is, magnitudes of fixation disparity and associated phoria, curve type and the central slope of the curve, was studied in 84 subjects because of ambiguity in the previous studies. It was found that the magnitudes of exo fixation disparity and exo associated phoria decreased significantly when they were measured with the central fusion lock. The central lock had no noticeable effect on the type of the curve, although, the central slope of the curve was flatter in the presence of the central lock.     

Transient synovitis of the hip in children: role of US

Transient synovitis of the hip remains a common diagnostic problem for the clinician. The physical signs are not pathognomonic of the condition, and the classic technical examinations are of little help. Therefore, the authors retrospectively studied the value of hip arthrosonography in 46 children with clinical symptoms suggesting pathologic hip conditions. In 20 of the 21 patients with a final diagnosis of transient synovitis, articular effusion was detected on ultrasound (US). Conventional radiography showed an increased medial joint space in only eight of these patients. Increased echogenicity of the articular fluid was found in both transient synovitis and septic arthritis. The high sensitivity of US in detecting intraarticular fluid was demonstrated by cadaver studies.     

Thoracic outlet syndrome: evaluation with CT

Diagnosis of the thoracic outlet syndrome is often difficult, particularly in patients without osseous abnormalities on plain radiographs. The radiographic and computed tomographic (CT) findings were reviewed from 27 patients with thoracic outlet syndrome and 21 normal subjects. The plain radiographs and CT scans were assessed by two independent observers without awareness of the clinical history. Fifteen patients with thoracic outlet syndrome had osseous abnormalities (anomalous cervical ribs; abnormally long, drooping C-7 transverse processes) identifiable on plain radiographs. CT did not provide further diagnostic information in the patients with abnormal radiographs. Eight of 12 patients (66%) with normal plain radiographs had abnormal findings on CT scans, consisting of impingement of the C-7 transverse process on the scalene triangle or anteromedial aspect of the middle scalene muscle. Only two of 21 control patients (9.5%) displayed this CT abnormality (P less than .01). CT may be useful in patients with symptoms suggestive of thoracic outlet syndrome and no osseous abnormalities on plain radiographs.